• Shunsuke Akashi, Maho Suzukawa, Keita Takeda, Isao Asari, Masahiro Kawashima, Nobuharu Ohshima, Eri Inoue, Ryota Sato, Masahiro Shimada, Junko Suzuki, Akira Yamane, Atsuhisa Tamura, Ken Ohta, Shigeto Tohma, Katsuji Teruya, and Hideaki Nagai.
• Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan; Shin-Yurigaoka General Hospital, Tokyo, Japan.
• J. Infect. Chemother. 2021 Apr 1; 27 (4): 617-624.

IntroductionThe new-generation QuantiFERON (QFT)-TB Gold Plus (QFT-Plus) is expected to be useful because it includes a new peptide that is supposed to induce a CD8+ T cell response. There is a need for a new marker with sensitivity higher than that of the conventional IFN-γ release assays owing to false-negative results in the latter. This study aimed to compare cytokines in QFT-plus and QuantiFERON-Gold In-Tube (QFT-GIT) supernatants to discriminate between active tuberculosis and latent tuberculosis infection (LTBI).MethodsA cross-sectional study was conducted at Tokyo National Hospital, wherein 21 LTBI patients and age and sex-matched active TB patients were randomly selected. The levels of various cytokines were measured and compared using the MAGPIX System, and receiver operating characteristic (ROC) curves were generated.ResultsIL-1RA, IFN-γ, CXCL10/IP-10, and CCL4/MIP-1β levels were higher in the active TB group than in the LTBI group in QFT-GIT antigen (GIT Ag) tubes. In QFT-plus tubes, IL-1RA was higher in TB1 and TB2 tubes, while CCL2/MCP-1 was higher only in TB2 tubes. In Nil tubes, CCL5/RANTES, TNF-α, PDGF-BB, and IL-2 levels were significantly higher in the active TB group. IL-1RA in GIT Ag tubes showed the highest area under the curve of 0.8367. The sensitivity and specificity of IL-1RA were 66.7% (95% confidence interval [CI]: 43.0-85.4) and 90.5% (95% CI: 69.6-98.8), respectively, which were the highest among the cytokines.ConclusionsIL-1RA level in the QFT-GIT supernatant can be a good marker for discriminating active TB from LTBI.Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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